Exploring the experiences, psychological well-being and needs of frontline healthcare workers of government hospitals in India: a qualitative study

Abstract

The present study aims to understand the experiences, challenges, psychological well-being and needs of clinical and non-clinical government healthcare workers (HCWs) during the COVID-19 pandemic in the Hyderabad-Karnataka (H-K) region. This qualitative study used purposive sampling method to recruit 221 HCWs working in the H-K region government hospitals during the COVID-19 pandemic. Semi-structured interviews were carried out with those HCWs who agreed to participate. The data analyzed using conventional content analysis revealed three main themes: (1) experiences and challenges faced by HCWs; (2) psychological well-being and coping strategies used by HCWs; and (3) experience of and need for social support. The main findings of the current study are as follows: The HCWs experienced fear and apprehension during the early stages of the pandemic, but gradually, their fears reduced, and they perceived the situation to be the “new normal”. They experienced work-related (scarcity of resources, problems with PPE, communication issues, violence, and stigma) and family-related (fear of infecting family members, choosing work over family, inability to undertake family roles) challenges while serving during the pandemic. They reported increased psychological issues (psychological distress, experience of loss, and feelings of guilt and helplessness). Conversely, they reported a need for emotional stability. The HCWs reported using adaptive (emotion-focused, problem-focused, and religious) and maladaptive (avoidance and substance abuse) coping strategies to cope with these challenges and psychological problems. They also sought social support (from family, friends, colleagues, and superiors) and raised the need for organizational, personal, and societal support to cope with the pandemic. The HCWs experienced physical and psychological burnout, especially from stretching beyond the assigned roles due to a shortage of resources and workforce. However, amidst juggling with work and family responsibilities, HCWs were found to be emotionally stable and reported to have a positive outlook in general. Besides, emphasizing the regulation of policies for meeting their primary needs, they stressed the need for professional psychological services with need-based intervention strategies.